New York, August 19, 2004, 7:00 PM
doctors', medics' role in Iraq prison
London -- Doctors working for
the U.S. military in Iraq collaborated with
interrogators in the abuse of detainees at
Baghdad's Abu Ghraib prison, profoundly breaching
medical ethics and human rights, a bioethicist
charges in The Lancet medical
In a scathing analysis of the behavior of
military doctors, nurses and medics, University of
Minnesota professor Steven Miles calls for a
reform of military medicine and an official
investigation into the role played by physicians
and other medical staff in the torture scandal.He
cites evidence that doctors or medics falsified
death certificates to cover up homicides, hid
evidence of beatings and revived a prisoner so he
could be further tortured. No reports of abuses
were initiated by medical personnel until the
official investigation into Abu Ghraib began, he
"The medical system collaborated with designing
and implementing psychologically and physically
coercive interrogations," Miles said in this week's
edition of Lancet. "Army officials stated that a
physician and a psychiatrist helped design, approve
and monitor interrogations at Abu Ghraib."
The analysis does not shed light on how many
doctors were involved or how widespread the problem
of medical complicity was, aspects that Miles said
he is now investigating.A U.S. military spokesman
said the incidents recounted by Miles came
primarily from the Pentagon's own investigation of
"Many of these cases remain under investigation
and charges will be brought against any individual
where there is evidence of abuse," said Lt. Col.
Barry Johnson, U.S. Army spokesman for detainee
operations in Iraq.
In a related matter, two military officials in
Washington said Thursday that a high-level Army
inquiry will cite medical personnel who knew of
abuse at Abu Ghraib but did not report it up the
chain of command.
The inquiry also will criticize senior U.S.
commanders for a lack of leadership that allowed
abuses to occur, but finds no evidence they ordered
the abuse, said the sources, who spoke condition of
Photographs of prisoners being abused and
humiliated by U.S. troops in Iraq have sparked
worldwide condemnation. Although the conduct of
soldiers has been scrutinized, the role of medical
staff in the scandal has received relatively little
"The detaining power's health personnel are the
first and often the last line of defense against
human rights abuses. Their failure to assume that
role emphasizes to the prisoner how utterly beyond
humane appeal they are," Miles said in a telephone
interview with The Associated Press.
He said military medicine reform needs to be
enshrined in international law and include more
clout for military medical staff in the defense of
human rights.Miles gathered evidence from U.S.
congressional hearings, sworn statements of
detainees and soldiers, medical journal accounts
and press reports to build a picture of physician
complicity, and in isolated cases active
participation by medical personnel in abuse at the
Baghdad prison, as well as in Afghanistan and at
the Guantanamo Bay detention center in Cuba.
In one example, cited in a sworn statement from
an Abu Ghraib detainee, a prisoner collapsed and
was apparently unconscious after a beating. Medical
staff revived the detainee and left, allowing the
abuse to continue, Miles reported.
Depositions from two detainees at Abu Ghraib
described an incident in which a doctor allowed a
medically untrained guard to sew up a prisoner's
wound.A military police officer reported a medic
inserted an intravenous tube into the corpse of a
detainee who died while being tortured to create
evidence that he was alive at the hospital, Miles
At prisons in both Iraq and Afghanistan,
"Physicians routinely attributed detainee deaths on
death certificates to heart attacks, heat stroke or
natural causes without noting the unnatural (cause)
of the death," Miles wrote.
He cites an example from a Human Rights Watch
report in which soldiers tied a beaten detainee to
the top of his cell door and gagged him. The death
certificate indicated he died of "natural causes
... during his sleep."
However, after media coverage, the Pentagon
changed the cause of death to homicide by blunt
force injuries and suffocation.
Dr. Robert Jay Lifton, a psychiatrist at
Harvard University-affiliated Cambridge Hospital
who wrote a book on doctors and torture in Nazi
Germany, called The Lancet analysis "a very
good, detailed description of violations of medical
policies involving medical ethics."
In a July 29 New England Journal of Medicine
essay, Lifton urged medics to report what they know
about American torture at Abu Ghraib and other
prisons, and said in an interview Thursday that a
non-military-led investigation of doctors' conduct
"They made choices," he said. "No doctor would
have been physically abused or put to death if he
or she tried to interrupt that torture. It would
have taken courage, but it was a choice they
The World Medical Association, an umbrella group
for national medical associations, reiterated its
policy of condemning any doctor's involvement in
abuse or torture of detainees.In an editorial
comment, The Lancet condemned the behavior
of the doctors, saying that despite dual loyalties,
they are doctors first and soldiers second.
"Health care workers should now break their
silence," the journal said. "Those who were
involved or witnessed ill-treatment need to give a
full and accurate account of events at Abu Ghraib
and Guantanamo Bay. Those who are still in
positions where dual commitments prevent them from
putting the rights of their patients above other
interests should protest loudly and refuse
cooperation with authorities."
Johnson, the Army spokesman, said the U.S.
military "will allow no actions that undermine or
compromise medical professionals' commitment to
caring for the sick and wounded, regardless of who
they are or their circumstances."
In his article, Miles dismissed Pentagon
officials putting the blame for the abuse on poor
training, understaffing, racism, pressure to
procure intelligence and the stress of
war."Fundamentally, however, the stage for these
offenses was set by policies that were lax or
permissive with regard to human rights abuses, and
a military command that was inattentive to human
rights," Miles concluded.
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